RESUMO
This study aims to investigate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in ESCC patients receiving neoadjuvant concurrent chemoradiotherapy (CCRT), and the efficacy of apparent diffusion coefficient (ADC) values in predicting pathologic response to neoadjuvant CCRT. Twenty-eight locally advanced ESCC patients treated with neoadjuvant CCRT followed by radical resection were prospectively enrolled. DW-MRI was recommended to be performed within 2 weeks before and 4-6 weeks after neoadjuvant CCRT. The calculated ADCs pre- (ADC1) and post- (ADC2) neoadjuvant CCRT, the definite (ΔADC) and percentage changes (ΔADC%) were analyzed for the efficacy of predicting pathologic response to neoadjuvant CCRT. Twenty patients had been identified as responders (tumor regression grade 1-2). Among them, ADC2 (3.02 ± 0.84 vs. 2.12 ± 0.44 × 10-3 mm2/s, P = 0.001) and ΔADC (1.22 ± 0.78 vs 0.64 ± 0.26 × 10-3 mm2/s, P = 0.007) were significantly higher than those of nonresponders (tumor regression grade: 3-5). Receiver operating characteristic analysis revealed that ADC2 exhibited an overall accuracy of in 71.4% in predicting pathologic response, with a sensitivity of 60.0%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 50.0%, when 3.04 × 10-3 mm2/s was used as the cutoff value. ADC value could be useful in predicting pathologic response to neoadjuvant CCRT in ESCC patients. High postneoadjuvant CCRT ADC is a predictive indicator for good response.
Assuntos
Carcinoma de Células Escamosas , Quimiorradioterapia/métodos , Imagem de Difusão por Ressonância Magnética/métodos , Neoplasias Esofágicas , Terapia Neoadjuvante/métodos , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/terapia , China , Precisão da Medição Dimensional , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/terapia , Carcinoma de Células Escamosas do Esôfago , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Prognóstico , Sensibilidade e Especificidade , Resultado do TratamentoRESUMO
Retreatment of tuberculosis (TB) often fails in China, yet the risk factors associated with the failure remain unclear. To identify risk factors for the treatment failure of retreated pulmonary tuberculosis (PTB) patients, we analyzed the data of 395 retreated PTB patients who received retreatment between July 2009 and July 2011 in China. PTB patients were categorized into 'success' and 'failure' groups by their treatment outcome. Univariable and multivariable logistic regression were used to evaluate the association between treatment outcome and socio-demographic as well as clinical factors. We also created an optimized risk score model to evaluate the predictive values of these risk factors on treatment failure. Of 395 patients, 99 (25·1%) were diagnosed as retreatment failure. Our results showed that risk factors associated with treatment failure included drug resistance, low education level, low body mass index (6 months), standard treatment regimen, retreatment type, positive culture result after 2 months of treatment, and the place where the first medicine was taken. An Optimized Framingham risk model was then used to calculate the risk scores of these factors. Place where first medicine was taken (temporary living places) received a score of 6, which was highest among all the factors. The predicted probability of treatment failure increases as risk score increases. Ten out of 359 patients had a risk score >9, which corresponded to an estimated probability of treatment failure >70%. In conclusion, we have identified multiple clinical and socio-demographic factors that are associated with treatment failure of retreated PTB patients. We also created an optimized risk score model that was effective in predicting the retreatment failure. These results provide novel insights for the prognosis and improvement of treatment for retreated PTB patients.
Assuntos
Antituberculosos/administração & dosagem , Modelos Teóricos , Tuberculose Pulmonar/tratamento farmacológico , Adulto , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Retratamento/estatística & dados numéricos , Fatores de Risco , Falha de TratamentoRESUMO
AIM: The aim of the study was to evaluate the impact of three-dimensional endoanal ultrasound (3D-EAUS) on postoperative outcome in patients with anal fistula. METHOD: This prospective study compared clinical and functional outcomes of patients with and without preoperative 3D-EAUS examination 1 year after anal fistula surgery. Patients were prospectively followed and evaluated by a standardized protocol including physical examination, the Wexner Incontinence Score (WIS) and anorectal manometry, at baseline and 1 year after surgery. RESULTS: A total of 196 patients were enrolled. There were no significant differences in demographic and operative parameters, except for operation time, between the two groups. At 1 year follow-up, the overall recurrence rates were 8.8% (9/102) in the 3D-EAUS group and 13.8% (13/94) in the examination under anaesthesia (EUA) group. In the subgroup of patients with complex fistulae, the recurrence rate was numerically lower in the 3D-EAUS group (12.8% vs 22.5%; P = 0.26). The WIS in the EUA group significantly worsened (0.35 ± 0.94 vs 1.07 ± 1.59; P = 0.003) with a decreased the number of fully continent patients (82.5% vs 55%; P = 0.008) while neither the WIS nor the proportion of fully continent patients changed in the 3D-EAUS group. Fewer patients in the 3D-EAUS group developed incontinence postoperatively (6.7% vs 33.3%; P = 0.012) and they had better maximum resting pressure and maximum squeeze pressure than the EUA group. CONCLUSIONS: Preoperative use of 3D-EAUS had a favourable impact on the outcome of surgical treatment for anal fistulae, especially in those with complex anal fistula. It should be routinely used in the clinical setting.
Assuntos
Canal Anal/diagnóstico por imagem , Endossonografia/métodos , Imageamento Tridimensional/métodos , Fístula Retal/diagnóstico por imagem , Fístula Retal/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Canal Anal/fisiopatologia , Canal Anal/cirurgia , Incontinência Fecal/etiologia , Incontinência Fecal/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Estudos Prospectivos , Fístula Retal/fisiopatologia , Recidiva , Resultado do Tratamento , Adulto JovemRESUMO
AIM: Moderate to severe pain after stapled haemorrhoidopexy (SH) is not uncommon. This study was designed to identify the predictors of postoperative pain after SH in a single centre. METHOD: Seventy-six patients with Grade II to IV haemorrhoids who underwent SH were selected from a prospectively compiled database. Preoperative data, including patient characteristics, manometry results and surgical data, were documented. Pain was evaluated during the first 24 h after the operation. Its intensity was classified into three grades according to the visual analogue scale (VAS) score: mild (VAS ≤ 3), moderate (VAS >3 to <5) and severe (VAS ≥ 5). Analgesics were not routinely given but were administered if the patient had moderate or severe pain. Both univariate and multivariate analyses were used to determine the predictors of postoperative pain. RESULTS: Moderate and severe pain was noted in 43 (58.9%) patients. No patient was readmitted due to persistent anal pain during the month following discharge. Postoperative pain was significantly associated with gender (P = 0.017), age (P = 0.014), first initial sensory volume (P = 0.023) and constipation (P = 0.005) in univariate analysis. Multivariate analysis identified male gender as an independent predictor of postoperative moderate to severe pain (P = 0.037, OR = 3.1, 95% CI 1.07-9.09). The initial sensory volume and preoperative coexisting constipation were negative predictors of postoperative moderate to severe pain after SH (P = 0.037, OR = 0.320, 95% CI 0.110-0.934, and P = 0.036, OR = 0.255, 95% CI 0.071-0.913, respectively). CONCLUSION: Male gender and the initial sensory volume are predictors of postoperative pain after SH. Anal manometry is recommended before the SH procedure. An active analgesia protocol should be considered for male patients with a low initial sensory volume after SH.
Assuntos
Diagnóstico Precoce , Hemorroidectomia/métodos , Hemorroidas/cirurgia , Medição da Dor/métodos , Dor Pós-Operatória/diagnóstico , Técnicas de Sutura/instrumentação , Suturas , Adulto , Idoso , China/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/epidemiologia , Estudos Retrospectivos , Fatores de Tempo , Adulto JovemRESUMO
Objective: To identify a novel reassortant H3N2 avian influenza virus using nanopore sequencing technology and analyze its genetic characteristics. Methods: The positive samples of the H3N2 avian influenza virus, collected from the external environment in the farmers' market of Guangzhou, were cultured in chicken embryos. The whole genome was sequenced by targeted amplification and nanopore sequencing technology. The genetic characteristics were analyzed using bioinformatics software. Results: The phylogenetic trees showed that each gene fragment of the strain belonged to the Eurasian evolutionary branch, and the host source was of avian origin. The HA gene was closely related to the origin of the H3N6 virus. The NA gene was closely related to the H3N2 avian influenza virus from 2017 to 2020. The PB1 gene was closely related to the H5N6 avian influenza virus in Guangxi Zhuang Autonomous Region and Fujian Province from 2016 to 2022 and was not related to the PB1 gene of the H5N6 avian influenza epidemic strain in Guangzhou. The other internal gene fragments had complex sources with significant genetic diversity. Molecular characteristics indicated that the strain exhibited the molecular characteristics of a typical low pathogenic avian influenza virus and tended to bind to the receptors of avian origin. On important protein sites related to biological characteristics, this strain had mutations of PB2-L89V, PB1-L473V, NP-A184K, M1-N30D/T215A, and NS1-P42S/N205S. Conclusions: This study identified a novel reassortant H3N2 avian influenza virus by nanopore sequencing, with the PB1 gene derived from the H5N6 avian influenza virus. The virus had a low ability to spread across species, but further exploration was needed to determine whether its pathogenicity to the host was affected.
Assuntos
Vírus da Influenza A Subtipo H3N2 , Influenza Aviária , Sequenciamento por Nanoporos , Filogenia , Vírus Reordenados , Animais , Vírus Reordenados/genética , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Influenza Aviária/virologia , Influenza Aviária/epidemiologia , Genoma Viral , Embrião de Galinha , Galinhas/virologia , Proteínas Virais/genética , Variação GenéticaRESUMO
OBJECTIVE: The purpose of this study was to investigate the effect of microRNA-206 on the malignant progression of renal clear cell carcinoma (RCC). In addition, whether microRNA-206 could regulate ZEB2 expression and the underlying mechanisms was also explored. PATIENTS AND METHODS: Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was performed to examine microRNA-206 level in 46 tumor tissue specimens and adjacent ones of RCC patients. Also, the relationship between microRNA-206 expression and clinical indicators of RCC was analyzed. The negative control (NC) and microRNA-206 mimics were transfected into RCC cell lines, and the transfection efficiency was verified by qRT-PCR. The effects of microRNA-206 on the proliferation and apoptosis of RCC cells were analyzed by cell counting kit-8 (CCK-8), clone formation, and flow cytometry assays. Finally, the regulation of microRNA-206 on the downstream gene ZEB2 was indicated by Western Blot and cell recovery experiments. RESULTS: qRT-PCR results showed that the expression level of microRNA-206 in tumor tissue samples of RCC patients was remarkably lower than that in adjacent normal tissues, and the difference was statistically significant. Meanwhile, compared with patients with high expression of microRNA-206, the pathological stage of patients with low expression of microRNA-206 was higher, and the overall survival rate was lower. In the RCC cell lines (Caki-1 and Caki-2), the cell proliferation ability of the microRNA-206 overexpression group was remarkably weakened, while the cell apoptosis rate was oppositely enhanced when compared with the NC group. In addition, this study demonstrated that ZEB2 expression was remarkably increased in RCC cells as well as tissues and was negatively correlated with microRNA-206 expression. At the same time, microRNA-206 mimics was found remarkably reduced in the expression of proteins in ZEB2-related signaling pathway, including ZEB2, ß-catenin, cyclinD1, c-Myc, MMP-2, and MMP-9. In the cell reverse experiment, the overexpression of ZEB2 was found to be able to counteract the impact of microRNA-206 mimics on RCC cell proliferation and apoptosis and thus, participated in the malignant progression of RCC. CONCLUSIONS: This study revealed that microRNA-206 was remarkably associated with the pathological stage and poor prognosis of RCC patients. In addition, microRNA-206 might inhibit the malignant progression of RCC by regulating the targeted ZEB2.
Assuntos
Carcinoma de Células Renais/genética , Proliferação de Células/efeitos dos fármacos , Neoplasias Renais/patologia , MicroRNAs/farmacologia , Idoso , Apoptose/efeitos dos fármacos , Carcinoma de Células Renais/mortalidade , Estudos de Casos e Controles , Linhagem Celular Tumoral/efeitos dos fármacos , Ciclina D1/metabolismo , Progressão da Doença , Feminino , Regulação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , MicroRNAs/genética , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas c-myc/metabolismo , Taxa de Sobrevida , Transfecção , Homeobox 2 de Ligação a E-box com Dedos de Zinco/efeitos dos fármacos , Homeobox 2 de Ligação a E-box com Dedos de Zinco/metabolismo , beta Catenina/metabolismoRESUMO
Objective:To study the disease characteristics in cases with benign paroxysmal positional vertigo(BPPV).Method:The characteristics and clinical features of 384 cases with BPPV were retrospectively analyzed,and all cases were treated with repositioning maneuver.The treatment outcomes were observed and analyzed during the follow-up period. Result:â Of the 384 cases,331(86.20%) cases were PC-BPPV, 47(12.24%) cases were HC-BPPV and 3(0.78%) cases were AC-BPPV, 3(0.78%) cases were combined semicircular canal BPPV. â¡All cases underwent repositioning maneuver, PC-BBPV cases first efficiency was 93.66%, long-term (six months) efficiency was 96.68%; HC-BBPV cases first efficiency was 91.49%, long-term (six months) efficiency was î95.74%î;AC-BPPV cases first efficiency and long-term efficiency were 66.67%;combined semicircular canal BPPV cases first efficiency and long-term efficiency were 66.67%.â¢Among 331 cases with PC-BBPV, cases diagnosed duct stones accounted for 96.37%,cases diagnosed crest stones accounted for 3.63%. Among 47 cases with HC-BBPV, cases diagnosed duct stones accounted for 78.72%ï¼cases diagnosed crest stones accounted for 21.28%.â£During the follow-up of six months,the recurrence rate was 12.76%(49/384). Conclusion:â In BPPV cases of Guangxi,the ratio of male and female,age of onset and the incidence of BPPV in each semicircular canal are consistent with other literatures.Geographical and ethnic factors do not affect the above results.â¡Repositioning maneuver is an simple and effective treatment for cases with BPPV.â¢There is higher recurrence rate in cases with BPPV after repositioning maneuver.
Assuntos
Posicionamento do Paciente , Canais Semicirculares/fisiopatologia , Vertigem Posicional Paroxística Benigna , China , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Objective: To describe the status and related factors of self-reported pain among working-age population in Inner Mongolia Autonomous Region (Inner Mongolia). Methods: A cross-sectional study was conducted. Data was from the Inner Mongolia fifth health services survey. SPSS 19.0 software package was used for data analysis and χ2 test was to compare the prevalence of self-reported pain in population with different characteristics. Unconditional logistic regression model was used to analyze the related factors on self-reported pain. Results: A total of 11 480 working-age population was involved in this survey, with prevalence of self-reported pain among working age population as 12.3%. The prevalence rates of moderate and severe pain were 11.6% and 0.7%, respectively. Results from the unconditional logistic regression analysis showed that, in the economically poor population, the risk of self-reported pain was 1.718 times of the relatively rich people (OR=1.718, 95%CI: 1.381-2.831). In the rural areas, the risk of self-reported pain was higher than that in the urban population (OR=2.506, 95%CI: 2.030-3.092) and people with chronic illnesses had 2.880 times higher risk than those who did not have the diseases (OR=2.880, 95% CI: 2.474-3.352). There was an interaction noticed between gender and age. Women at or above 45 years old were more likely to develop self-report pain (OR=1.300, 95% CI: 1.072-1.577). Again, factors as people who were current or former smokers, who were suffering from anxiety or depression, being skinny etc. appeared as independently related to the self-reported pain. Conclusion: In working age population of Inner Mongolia, a high prevalence of self-reported pain was seen. Data showed that people who were poor, age at 45 or older, having history of smoking, with chronic diseases and anxiety/depression were risk factors related to self-reported pain.
Assuntos
Dor , China , Doença Crônica , Estudos Transversais , Transtorno Depressivo , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Autorrelato , Fumar , Inquéritos e Questionários , População UrbanaRESUMO
It is reported that a FI on-line co-precipitation technique for the pre-concentration of trace amount of Sn with the precipitate of Mg(OH)2 as carrier is hyphenated with AFS determination. The co-precipitation is carried out in NaOH medium and the precipitate is collected in a precipitation collector. The precipitate is then dissolved by HCl and reacted with NaBH4, the hydride is transferred directly into the atomizer. The relative standard deviation is 5.15% for 10 determinations of 30 ng.mL-1 Sn and the detection limit of 0.21 ng.g-1 is obtained. The developed method has been applied to the determination of trace Sn in geosamples with satisfactory results.
Assuntos
Estanho/análise , Precipitação Química , Análise de Injeção de Fluxo/métodos , Hidróxido de Magnésio , Sensibilidade e Especificidade , Hidróxido de Sódio , Espectrometria de Fluorescência/métodos , Espectrofotometria Atômica/métodosRESUMO
The E2 genes of 73 classical swine fever virus (CSFV) originated from CSF suspected cases in different regions of China were genetically characterized and compared with reference CSF viruses. All Chinese viruses that characterized were segregated into two major groups and subdivided into four subgroups. Most of isolates (61.6%) belonged to group 2 and were further divided into three subgroups: subgroup 2.1, 2.2 and 2.3. Subgroup 2.1 was the largest subgroup which contained 46.6% of isolates, while subgroup 2.3 was the smallest subgroup which contained only one isolate (1.4%). The remaining 38.4% of isolates were classified into subgroup 1.1 within group 1. However, no group 3 and subgroups 1.2 and 1.3 viruses were found in this study. This study has provided epidemiological information useful for assessing the virus origin and establishing a national prevention and control strategy against the disease.
Assuntos
Vírus da Febre Suína Clássica/classificação , Vírus da Febre Suína Clássica/genética , Peste Suína Clássica/virologia , Surtos de Doenças/veterinária , RNA Viral/genética , Animais , China/epidemiologia , Peste Suína Clássica/epidemiologia , Vírus da Febre Suína Clássica/isolamento & purificação , Filogenia , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Suínos , Proteínas do Envelope Viral/genéticaRESUMO
AIM: To evaluate the sealing ability of calcium sulphate when used under composite resin for the repair of furcation perforations having different diameters. METHODOLOGY: Perforations of different diameter were created in the floors of pulp chambers in 60 extracted human molar teeth with either a number 3 (1 mm diameter) or 5 (1.5 mm diameter) round bur. The specimens of each group were divided into four sub-groups which were repaired with composite resin either alone or in combination with calcium sulphate that created an artificial floor (15 teeth group(-1)). Eight teeth without furcation perforations served as negative controls. In the leakage detection device, 1 mol L(-1) glucose solution was forced under a pressure of 1.5 KPa from the crown towards the pulp chamber floor. The concentration of leaked glucose was measured at 1, 2, 4, 7, 10, 15 and 20 days using a glucose oxidase method and the data evaluated using the rank sum test. RESULTS: The specimens with larger perforations repaired with composite resin alone had significantly more leakage (P < 0.05). Using calcium sulphate as an artificial floor significantly decreased leakage of smaller perforations (P < 0.05). In groups repaired with calcium sulphate under composite resin, leakage in smaller perforations was markedly lower than that in larger ones (P < 0.05). No significant difference was found between the specimens with 1 or 1.5 mm perforations repaired with resin alone (P > 0.05). CONCLUSIONS: Calcium sulphate significantly improved the sealing ability of 1 mm perforations repaired with composite resin but not for 1.5 mm perforations.
Assuntos
Sulfato de Cálcio/uso terapêutico , Resinas Compostas/uso terapêutico , Infiltração Dentária/prevenção & controle , Materiais Dentários/uso terapêutico , Cavidade Pulpar/lesões , Traumatismos Dentários/terapia , Raiz Dentária/lesões , Instrumentos Odontológicos/efeitos adversos , Humanos , Metacrilatos/uso terapêutico , Dente Molar , Cimentos de Resina/uso terapêuticoRESUMO
Routinely sterilized surgical instruments were divided into two groups and put on the same instrument table, one group was covered with dressing and the other was exposed to the air. The samples were collected at 30 min, 60 min, and 90 min respectively after operation began and bacterium culture was done. The results showed that the general air contamination rate of the exposed group was 1.18 times higher than that of the covered one. The exposure time had a positive correlation with bacterium contamination rate. This study gave the laboratory evidence for controlling the infection in the operation room.